• Increased risk of pulmonary complications with surgery.
  • Smoking should stop at 4-8 weeks prior to elective surgery.
  • WHO reports patients who quit smoking at least four weeks before an operation...have substantially improved outcomes, with fewer post-surgical infections and a reduced probability that they will have to return to the hospital for additional care.
  • Smoking decrease bone healing. (W-Dahl A, Toksvig-Larsen S. Cigarette smoking delays bone healing: a prospective study of 200 patients operated on by the hemicallotasis technique. Acta Orthop Scand. 2004 Jun;75(3):347-51.)
  • Non-smokers and prior smokers who quite a minimum of 1 year prior to TJA have a lower risk of wound complication after TJA. (Duchman K,  ORS annual meeting 2015)
  • Nicotine caused a delay in tendon-to-bone healing in a rat rotator cuff animal model.  (Galatz, LM, JBJS 2006;88A:2027)